Norhayati Mohd Zain

Breast Imaging Using Electrical Impedance Tomography: Correlation of Quantitative Assessment with Visual Interpretation

BACKGROUND Electrical impedance tomography (EIT) is a new non-invasive, mobile screening method which does not use ionizing radiation to the human breast; allows conducting quantitative assessment of the images besides the visual interpretation. The aim of this study was to correlate the quantitative assessment and visual interpretation of breast electrical impedance tomographs and associated factors. MATERIALS AND METHODS One hundred and fifty mammography patients above 40 years and undergoing EIT were chosen using convenient sampling. Visual interpretation of the images was carried out by a radiologist with minimum of three years experience using the breast imaging - electrical impedance (BI-EIM) classification for detection of abnormalities. A set of thirty blinded EIT images were reinterpreted to determine the intra-rater reliability using kappa. Quantitative assessment was by comparison of the breast average electric conductivity with the norm and correlations with visual interpretation of the images were determined using Chi-square. One-way ANOVA was used to compare the mean electrical conductivity between groups and t-test was used for comparisons with pre-existing Caucasians statistics. Independent t-tests were applied to compare the mean electrical conductivity of women with factors like exogenous hormone use and family history of breast cancer. RESULTS The mean electrical conductivity of Malaysian women was significantly lower than that of Caucasians (p<0.05). Quantitative assessment of electrical impedance tomography was significantly related with visual interpretation of images of the breast (p<0.05). CONCLUSIONS Quantitative assessment of electrical impedance tomography images was significantly related with visual interpretation.

Association of bone mineral density and mammographic breast density in premenopausal and postmenopausal Malaysian women: Study on women with and without breast cancer

High mammographic breast density is an established risk factor for breast cancer whilst bone mineral density is a marker of estrogen cumulative exposure. This study was conducted to compare bone mineral density in Malaysian premenopausal and postmenopausal women; with and without breast cancer. Besides, it was to determine the relationship between bone mineral density and mammographic breast density in these groups. A cross-sectional study on 50 women above 40 years old who underwent mammogram and Dual Energy X-ray Absorptiometry was conducted at the General Hospital Kuala Lumpur for a year. Respondents were chosen using purposive sampling and women who had commenced cancer treatment were excluded from the study. The mean of selected characteristics were compared between groups using independent-t and Mann-Whitney U for continuous and categorical data respectively whilst Chi-square analysis was used to determine the association of bone mineral density and mammographic breast density. A total of 31 and 19 pre- and postmenopausal women respectively. Women with scattered fibroglandular breasts were the most affected by cancer, although, there was no statistical difference (p=0.298). There was no significant difference in women with contraceptive and/or hormone replacement therapy usage with breast density based on the classification of bone mineral density (p=0.214), cancer (p=0.344) and menstrual status (p=0.298). In conclusion, there was an adverse association between bone mineral density and mammographic breast density in both premenopausal and postmenopausal women; with and without breast cancer.

Is There a Relationship Between Bone Mineral Density, Mammographic Breast Density and Serum Estrogen Concentration Level? Study on Malaysian Women

Estrogen is known to affect both mammographic breast density and bone mineral density. Breast density is a well-known risk factor of breast cancer determined by the physiological hormonal changes. Studies shown inconclusive relationship of breast density and bone mineral density as breast cancer risk factors. This study aimed to determine the relationship of bone mineral density; mammographic breast density and serum estrogen concentration level in Malaysian women. A cross sectional study on 108 women aged above 40 years who underwent bone scan and mammography screening was conducted at the General Hospital Kuala Lumpur from 2016 to 2017. Subjects were chosen using convenient sampling technique. With women commenced cancer treatment and women who had mastectomy done being excluded from the study. An independent-t and chi-square statistical test were used to analyze the continuous and categorical data whilst binary logistic regression was used to determine the mentioned relationship. A total of 75.5% of the respondents had a normal bone mineral density in the hip and 76.9% in the spine. Abnormality in bone mineral density were recorded to be higher in postmenopausal women with the bone mineral density in spine (23.2%) region were slightly higher compared to the hip (18.5%). There was no statistical significant relationship between mammographic breast density and serum concentration level with bone mineral density in hip and spine.